As the use of fentanyl, a powerful opioid drug, has skyrocketed across Canada, so have overdose deaths. That has left frontline agencies scrambling, including those in Quebec.

While British Colombia and Alberta have found themselves at the epicenter of the crisis, Quebec has also been hit hard and is lagging behind, said Marie-Eve Morin, a family physician who works with many addicts, some of whom have died of overdoses.

“People have difficulty accessing treatments because there are not enough physicians prescribing methadone,” she said.

Fentanyl has 40 times the strength of heroin and 100 times that of morphine. Compounding the problem is that it is cheap to produce.

Quebec’s public health department was not available for comment.

Jessica Turmel, who does outreach work at festivals and events, said she has seen a surge in use. She said she always carries a box of naloxone when she’s out, a drug that block the effects of opioids and is used for overdosing users.

“Some people consume (fentanyl) voluntarily,” she said. “But many others consume is involuntary. That’s a big public health problem.”

Morin agreed with that assessment.

“If you have an OD of opiates, you stop breathing,” she said. “It’s not like cocaine or speed. If you use fentanyl without knowing it, that’s very dangerous.”

The federal government has taken steps to ban the importing of chemicals used to produce fentanyl and has called for an opioid summit this fall.

Jean-Francois Marie, a spokesperson for drug user health advocacy group AQPSUD, said that ban won’t do much good, as most fentanyl is produced in China.

“It would be better to change the regulations around drugs and facilitating safe injection sites and providing the adequate amount of naloxone to users,” he said.

He added that many drug users are reluctant to call for help when they most need it.

“Now, with the prohibition system, people are dying behind closed doors,” he said. “There’s no one to reach out to.”